Suggested Use:

Take 4 capsules (1 serving) daily, preferably with a meal, or as directed by a physician. For those with a sensitive constitution, take ½ of a serving (2 capsules) at once, twice per day.

Caution: 

Use only as directed. Consult your healthcare provider before use if you are contemplating pregnancy, pregnant, nursing, have any medical conditions, or use any medications. For adult use only. Keep this product out of reach of children. Do not use if tamper evident seal is broken or missing. Store in a cool, dry place. 

Warning: This product contains 100% or more of the daily recommended amount of folate; do not use it alongside other products that contain high amounts of folate, as this could lead to overconsumption of folate. Possible signs and symptoms of overconsumption include upset stomach, nausea, diarrhea, irritability, confusion, behavior changes, and skin reactions.

Please use caution when taking this product alongside any other supplement or medication that can lower blood sugar levels as this combination may increase the risk of hypoglycemia. 

Please note that use of this product can lead to hypoglycemia (low blood sugar levels) for some individuals. Symptoms of hypoglycemia include, but are not limited to:

Looking pale (pallor)
Shakiness
Dizziness or lightheadedness
Sweating
Hunger or nausea
An irregular or fast heartbeat
Difficulty concentrating
Feeling weak and having no energy (fatigue)
Irritability or anxiety
Headache
Tingling or numbness of the lips, tongue or cheek
Damp sheets or nightclothes due to perspiration
Nightmares
Tiredness, irritability or confusion upon waking 1

If you experience any of these symptoms when using this product, please stop using it immediately and contact your healthcare provider. If they determine it’s causing hypoglycemic symptoms, you may need to reduce your serving size, change the time of day you take it, or stop taking it entirely.
 

[1] Williams, T., Mortada, R., & Porter, S. (2016). Diagnosis and treatment of polycystic ovary syndrome. American Family Physician, 94(2), 106-113. Retrieved from: https://www.aafp.org/afp/2016/0715/p106.html#sec-5

[2] Benelli, E., Del Ghianda, S., Di Cosmo, C., & Tonacchera, M. (2016). A combined therapy with myo-inositol and d-chiro-inositol improves endocrine parameters and insulin resistance in PCOS young overweight women. International Journal of Endocrinology. DOI: http://dx.doi.org/10.1155/2016/3204083

[3] Sortino, M. A., Salomone, S., Carruba, M. O., & Drago, F. (2017). Polycystic ovary syndrome: insights into the therapeutic approach with inositols. Journal Frontiers in Pharmacology, 8(341), 1-13. DOI: 10.3389/fphar.2017.00341

[4] Troisi, J., Cinque, C., Giugliano, L., Symes, S., Richards, S., Adair, D., Cavallo, P., Sarno, L., Scala, G., Caiazza, M., & Guida, M. (2019). Metabolomic change due to combined treatment with myo-inositol, d-chiro-inositol and glucomannan in polycystic ovarian syndrome patients: a pilot study. Journal of Ovarian Research, 12(25). DOI: https://doi.org/10.1186/s13048-019-0500-x 

[5] Kalra, B., Kalra, S., & Sharma, J. (2016). The inositols and polycystic ovary syndrome. Indian Journal of Ednocrinology and Metabolism, 20(5), 720-724. DOI: 10.4103/2230-8210.189231 

[6] Unfer, V., Facchinetti, F., Orru, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647-658. DOI: 10.1530/EC-17-0243 

[7] Centers of Disease Control and Prevention. (2018, April 11). Folic acid. https://www.cdc.gov/ncbddd/folicacid/faqs/faqs-general-info.html

[8] Melitis, C. Folate vs. folic acid – facts about vitamin B. American Pregnancy Association. https://americanpregnancy.org/infertility/folate-vs-folic-acid-what-you-need-to-know/ 

[9] National Institutes of Health. (2020, March 11). Folate. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/ 

[10] Lynch, B. L-methylfolate, methylfolate, 5-MTHF, L-5-MTHF. What is the difference?! http://mthfr.net/l-methylfolate-methylfolate-5-mthf/2012/04/05/ 

[11] Stracquadanio, M., Ciotta, L., & Palumbo, M. A. (2018). Effects of myo-inositol, gymnemic acid, and L-methylfolate in polycystic ovary syndrome patients. Gynecological Endocrinology, 34(6), 495-501. DOI: 10.1080/09513590.2017.1418852 

[12] Scaglione, F., & Panzavolta, G. (2014). Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica, 44(5), 480-488. DOI: 10.3109/00498254.2013.845705 

[13] Obeid, R., Holzgreve, W., & Pietrzik, K. (2013). IS 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? Journal of Perinatal Medicine, 41(5), 469-483. DOI: 10.1515/jpm-2012-0256 

[14] Fu, L., Dai, L., Li, X., Zhang, K., & Bai, Y. (2014). Association of methylenetetrahydrofolate reductase gene C677T polymorphism with polycystic ovary syndrome risk: a systematic review and meta-analysis update. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 172, 56-61. DOI: 10.1016/j.ejogrb.2013.10.001 

[15] Diwaker, A., & Kishore, D. (2018). Evaluation of plasma homocysteine levels in patients of PCOS. The Journal of the Association of Physicians of India, 66(10), 17-20. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/31317701/?from_term=pcos+homocysteine&from_pos=1 

[16] Schachter, M., Raziel, A., Friedler, S., Strassburger, D., Bern, O., & Ron-El, R. (2003). Insulin resistance in patients with polycystic ovary syndrome is associated with elevated plasma homocysteine. Human Reproduction, 18(4), 721-727. DOI: 10.1093/humrep/deg190 

[17] Badawy, A., State, O., Sh Abd El Gawad, S., & Abd El Aziz, O. (2007). Plasma homocysteine and polycystic ovary syndrome: the missed link. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 131(1), 68-72. DOI: 10.1016/j.ejogrb.2006.10.015

 [18] Saadeh, N., Alfaqih, M. A., Mansour, H., Khader, Y. S., Saadeh, R., Al-Dwairi, A., & Nusier, M. (2018). Serum homocysteine is associated with polycystic ovary syndrome in Jordan. Biomedical Reports, 9(5), 439-445. DOI: 10.3892/br.2018.1149 

[19] Linus Pauling Institute. (2017, October). Vitamin D. https://lpi.oregonstate.edu/mic/vitamins/vitamin-D

[20] Harvard T.H. Chan School of Public Health. (2020, March). Vitamin D. https://www.hsph.harvard.edu/nutritionsource/vitamin-d/ 

[21] Krul-Poel, Y. H. M., Snackey, C., Louwers, Y., Lips, P., Lambalk, C. B., Laven, J. S. E., & Simsek, S. (2013). The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review. European Journal of Endocrinology, 169(6), 853-865. DOI: 10.1530/EJE-13-0617

[22] Krul-Poel, Y. H. M., Koenders, P. P., Steegers-Theunissen, R. P., Ten Boekel, E., Ter Wee, M. M., Louwers, Y., Lips, P., Laven, J. S. E., & Simsek, S. (2018). Vitamin D and metabolic disturbances in polycystic ovary syndrome (PCOS): a cross-sectional study. PLoS One, 13(12). DOI: 10.1371/journal.pone.0204748 

[23] He, C., Lin, Z., Robb, S. W., & Ezeamama, A. E. (2015). Serum vitamin D levels and polycystic ovary syndrome: a systematic review and meta-analysis. Nutrients, 7(6), 4555-4577. DOI: 10.3390/nu7064555 [24] Thomson, R. L., Spedding, S., Buckley, J. D. (2012). Vitamin D in the aetiology and management of polycystic ovary syndrome. Clinical Endocrinology, 77(3), 343-350. DOI: 10.1111/j.1365-2265.2012.04434.x 

[25] Dastorani, M., Aghadavod, E., Mirhosseini, N., Foroozanfard, F., Modarres, S. Z., Siavashani, M. A., & Asemi, Z. (2018). The effects of vitamin D supplementation on metabolic profiles and gene expression of insulin and lipid metabolism in infertile polycystic ovary syndrome candidates for in vitro fertilization. Reproductive Biology and Endocrinology, 16(1), 94. DOI: 10.1186/s12958-018-0413-3 

[26] Javed, Z., Papageorgiou, M., Deshmukh, H., Kilpatrick, E. S., Mann, V., Corless, L., Abouda, G., Rigby, A. S., Atkin, S. L., & Sathyapalan, T. (2019). Nutrients, 11(1), 188. DOI: 10.3390/nu11010188 

[27] Kagowska, K., Bajerska, J., & Jamka, M. (2018). The role of vitamin D oral supplementation in insulin resistance in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Nutrients, 10(11), 1637. DOI: 10.3390/nu10111637